Did you know it is possible to prevent both short term and long term type 1 diabetes complications?
In fact, I didn’t know anything about type 1 diabetes until just over a year ago.
That was when our lives changed forever as our 4-year-old grandson was diagnosed with type 1 diabetes.
When type 1 diabetes remains untreated or poorly managed there are several complications that can arise.
Some of these complications are short term meaning they could occur at any time and require treatment immediately.
Some other complications may develop over time and many of them can actually be avoided by following a proper diabetes management plan as set forth by your diabetes management team.
Short Term Complications
Short term complications of type 1 diabetes can develop rather quickly… as I learned the hard way.
Back before the pandemic began I headed out to pick up our Grandson from school and bring him home to my place until his parents can drop by for him.
This one day I arrived as per normal to pick him up and stood just outside of his classroom waiting for him when I noticed something different.
He was quieter than normal… he seemed more drowsy and not quite himself.
I quickly grabbed the scanner and quietly snuck in to scan him, it was at 5.2 mmol.
Good, I thought, this is not too low and I can wait till I get him to the house 2 minutes away.
Once there I can treat and take care of him away from the busy school. I mean after all, it won’t change that much in a couple of minutes, right? Boy was I wrong.
When we got home I scanned him again and this time he was 4.2. Ok, I thought, he is dropping fast and the CGM has a delay of 15 minutes so I decided to do a finger poke as well to get more accurate numbers.
That’s when I started to panic a little. The finger poke told me he was actually at 3.6 and I could feel the adrenaline rush hit me.
I immediately got him some apple juice and 5 skittles ( a fruity candy kids love here) and told him, “Alex, I need you to drink and eat this right now. No playing around, eat them fast.) The sense urgency inside me wouldn’t let me leave his side to ensure that he got it in him immediately, which he did, thank goodness.
The juice and sweets act super fast so you can imagine my relief when I saw the numbers rise 15 minutes later.
BIG Lesson learned that day.
As you can see the numbers can change drastically in a short period of time so my advice to you is:
- monitor frequently
- and never wait, not even for 2 minutes…
OK, you can see what happens when they have low blood sugar levels right? But, what happens when you give them too much insulin?
Well first it’s not good, but why is it not good?
Hypoglycemia (low blood sugar) which occurs when they have not eaten enough or they have taken too much insulin.
As you can see, both these cases (not enough food or too much insulin) will have the same effect.
As in my story above, Alex had Hypoglycemia because he:
- either never ate all his lunch or it was not enough for his activities OR
- the teacher gave him a little too much insulin to balance his food
There are other possible causes for Hypoglycemia and they include, taking over 81 mg of aspirin or alcohol consumption.
There are three stages of hypoglycemia and it is best to treat when in the mild or moderate stage.
When it comes to Hypoglycemia the symptoms of the Mild and Moderate stages tend to overlap. Only the numbers really tell which stage you are in.
In the mild stage, blood sugar levels are less than 3.8 but more than 2.9, in the moderate stage levels are below 2.9 and in the severe stage, the person is unable to treat themself due to physical or mental changes. They may even be unconscious.
The initial symptoms for mild to moderate hypoglycemia can include:
- fast heartbeat
- inability to concentrate
- irritability or moodiness
- anxiety or nervousness
Severe Hypoglycemia symptoms include:
- clumsiness or jerky movements
- inability to eat or drink
- muscle weakness
- slurred speech or difficulty speaking
- blurry or double vision
- convulsions or seizures
- in rare cases, death
Hyperglycemia is when blood glucose is too high and can affect both type 1 and type 2 diabetics.
There are 2 main types of hyperglycemia:
- fasting hypoglycemia – blood sugars remain high after not eating or drinking for 8 or more hours
- postprandial (after meal) hypoglycemia – when blood sugars remain high 2 or more hours after eating
Just like Hypoglycemia, Hyperglycemia is also very dangerous but for other reasons.
If left untreated hyperglycemia can cause damage to nerves, blood vessels, organs and can also lead to diabetic ketoacidosis (DKA) which is very serious.
Recently, we decided to take the kids on a 3-day sail trip on the Grand Lake which the kids participated in activities that kept them busy and entertained.
Throughout the day ((Recently, when we took our grandkids out sailing)) I noticed Alex was running quite high at 18 mmol. This became a big concern for me and even though the kids were having a time of their life I was beginning to worry some.
Here we are in the middle of a huge lake with no cell service and all we had was the marine radio to call for help if we needed it. I continued to keep an eye on him and even at mealtimes he would spike to 22 then come back down to around 18.
Just to give you an idea of what I was dealing with, our target range is around 8 so we are running much too high which is not cool because we are risking DKA.
After contacting his mom for assistance she suggested giving him an extra half shot of insulin because he has been so high for so long now.
That extra half dose finally got his numbers to start coming down which made me a very happy grandmother again, to say the least.
I naturally was testing for ketones because he had been high for much too long.
Thankfully there were no ketones present and this brings us to our next topic.
Diabetic ketoacidosis (DKA) is a serious and life-threatening complication of type 1 diabetes although in rare cases it can occur in type 2.
DKA occurs when blood sugars are very high for a prolonged period and acidic substances called ketones build up to dangerous levels in the body.
When a diabetic has had high blood glucose for a while it is important to test for ketones and if they are present seek medical treatment immediately.
Hence, this is what I was soooo concerned about on the boat trip. Even at one point I just wanted to stop all fun for Alex and head to the shore. We were able to get close enough to the shore to pick up a cell phone single and call his mom for assistance.
DKA requires treatment with a glucagon kit and hospitalization so it’s imperative to take it seriously.
The trick is to scan often and act immediately.
By being diligent in daily diabetes management you can avoid many of the long term complications of type 1 diabetes.
Follow your diabetes care plan exactly as directed by your health care team.
Eat a healthy diet, get regular exercise, and take all medications as directed.
Sometimes complications can arise in spite of our best efforts.
We all have small blood vessels through our bodies and poor blood glucose management can cause damage to these blood vessels leading to poor blood flow which can cause damage particularly to the eyes, kidneys, and nerves.
Common eye problems caused by type 1 diabetes is retinopathy and cataracts.
To avoid eye problems diligently manage blood glucose levels and have regular eye exams.
Poorly managed diabetes will often cause the kidneys to fail being unable to effectively clean the blood.
Kidney disease (diabetic nephropathy) often leads to dialysis and/or a kidney transplant. In order to prevent diabetic nephropathy, you (or your child/grandchild) should be tested yearly for microalbuminuria ( a condition that is an early sign of kidney problems).
This test measures the number of proteins in the urine. When kidneys begin to malfunction they start to release too much protein.
Nerve damage caused by diabetes is called diabetic neuropathy.
Symptoms depend on the site of the nerve damage but can include weakness, numbness, tingling, or pain.
Severe diabetic neuropathy in the feet or hands can result in amputation.
Type 1 diabetes can also affect the large blood vessels. The large blood vessels are those leading to the heart.
Uncontrolled type 1 diabetes can cause plaque to build up in the arteries which can lead to a heart attack or stroke.
It is important to follow your diabetes care plan closely as well as making other hearth healthy choices such as eating a healthy diet, getting regular exercise, don’t smoke, keep blood pressure and cholesterol levels in check, and regular doctor visits.
The truth is prevention is always better than trying to find a cure.
When it comes to preventing complications of type 1 diabetes common sense prevails.
Simply proper daily management of your diabetes will prevent most if not all complications from arising as you seen in the examples with Alex above.
Proper diabetes management includes frequently monitoring blood glucose (blood sugar).
This is done by either pricking the finger with a lancet and placing a drop of blood on the test strip which has been inserted into the blood glucose monitor or by wearing a CGM (continuous glucose monitor).
Our grandson wears a CGM but we also test traditionally with a finger poke before each meal or if he scans low.
This is to ensure we have accurate numbers in order to dose the proper amount of insulin at mealtimes or to treat a low when it occurs.
Take Daily Insulin on Time
Our grandson takes his long-lasting insulin at 7 each morning followed by his regular insulin with his breakfast and at each meal thereafter.
Yes, that is 4 injections a day, every day for the rest of his life.
Sometimes he is staying high after a meal which means we likely didn’t give him enough insulin. There have been times he has required a correction (another dose of insulin) to get him close to the target range as in the case on the sailing trip.
Eat a Healthy Diet
Eating a healthy diet is a part of any healthful living plan but it is an essential part of diabetes management.
No need to go crazy here with fancy restrictive diets.
Simply eat plenty of vegetables and fruits along with lean proteins and whole grains.
Your diabetes team will likely include a nutritionist to help determine the best diet plan for you.
Get regular exercise
Regular exercise is an important part of any healthy lifestyle.
For the type 1 diabetic regular exercise can actually help keep those blood glucose numbers close to the target range.
It also helps keep that heart-healthy which is helping to prevent one of the most common complications of diabetes.
Regular exercise could be as simple as a daily walk or as complicated as a professional athletes’ workout schedule.
There are certainly many professional athletes who successfully manage their type 1 in extreme circumstances.
Protect your feet
Since foot ulcers (sores that don’t heal) are a common problem it is important to check your feet daily for minor cuts and scratches.
It is also a good idea to wear close-toed shoes when outside in order to better protect the feet.
For a type 1 diabetic, daily foot care is essential.
Having high blood sugar can create ideal conditions for bacteria to grow inside the mouth. This leads to plaque build-up and, eventually cavities and/or gum disease.
Middle of the night treatment of lows with food or juice can also lead to further plaque buildup.
Regular dental visits are also important.
Regular doctor appointments
Keep all doctor appointments and follow your doctor’s advice.
Your doctor will want to test your A1c levels which is a test that can determine your blood sugar levels over the past 2 – 3 months.
Your doctor will use these numbers as a guide for how effective your diabetes care plan is and will make any adjustments based on this.
Discuss any concerns you have and work with your doctor to determine the best plan for you or your child/grandchild.
I find that many Type 1 Diabetes Complications can be prevented simply by following your diabetes care plan as set forth by your diabetes care team.
By frequently checking blood glucose levels and correcting any highs or lows you will help keep the body at its healthiest.
A well-balanced diet and ensuring you get regular exercise is also an important part of diabetes management.
Regular doctor and dentist visits will also contribute greatly to optimal health.
It is important to work closely with your doctor to help determine the best plan for your needs.
If you notice something doesn’t seem to be working for you be sure to discuss it with your doctor.
I would be interested to know if you were aware that many complications of type 1 diabetes could be prevented with diligent care?
Please share with is any tips have you found that work for you?
Leave your comments in the section below.